Division of Communicable Disease Control

Mpox Vaccine Eligibility Has Expanded!

Get your safe and effective mpox vaccine at a provider near you.

Check with your local health department (LHD) for more information on case reporting and treatment options available.

Mpox Guidance

Health Advisories and Updates

12/11/2023: Clade I Mpox Virus (MPXV) with Geographic Spread in the Democratic Republic of the Congo: Recommendations for California Health Care Providers – This advisory provides information on Clade I MPXV and specimen submission for clade-specific mpox testing if Clade I Mpox is suspected due to travel history to endemic areas.
10/30/2023: Increase in Mpox Cases in California: Updates on Identification, Laboratory Testing, Management and Treatment, and Vaccination for Mpox - This advisory provides an update on rising mpox cases and encourages providers to consider mpox in their differential diagnoses, test persons with suspected mpox, treat mpox, and offer vaccine to populations at increased risk to prevent severe mpox disease and reduce the number of new infections. 
5/30/2023: Preventing a Resurgence of Mpox Cases in California (PDF) – CDPH Dear Colleague letter to California providers to remain vigilant in mpox prevention, recognition, and testing, especially during the 2023 spring and summer season as people gather for festivals and events. Information on how to diagnose, test for, and vaccinate against mpox is included.
4/4/2023: Updates on Identification, Lab Testing, Management and Treatment, and Vaccination for Mpox Virus in California - This advisory provides an update on mpox case recognition, lab testing, vaccination, and management.

Health Care Providers

Topics: Clinical Recognition and Considerations | Mpox Treatment | Provider Reporting | Infection Prevention and Waste Management in Healthcare Settings

Clinical Recognitions and Considerations

Evaluation:

Clinical Assist Tool for Mpox Evaluation – CDPH guidance tool to aid clinicians in determining mpox diagnosis.
Clinical Recognition – CDC guidance on key mpox characteristics, clinical prodrome, and rash development.
CDC Clinical Guidance  – CDC guidance for healthcare providers for managing patients with mpox.

Testing:

Preparation and Collection of Specimens – CDC best practices for specimen collection. Please note, lesions do not need to be unroofed or aspirated; vigorous swabbing of the lesion is sufficient.

Home isolation guidance for patients:

Isolation and Infection Control at Home – CDC isolation guidance for persons with suspected or confirmed mpox infection.

Clinical considerations for special populations:

People Who are Pregnant or Breastfeeding - CDC guidance for mpox infection in people who are pregnant and/or breastfeeding. 
People with HIV and Other Immunocompromising Conditions - CDC guidance for patients with HIV who might or have been exposed to mpox. 
Ocular Infection – CDC interim guidance for mpox infection involving the eyes, including symptomatic management.
Children and Adolescents – CDC guidance for healthcare providers assisting those under the age of 18.
Consent to Medical Services for the Treatment of Mpox in Minors - CDPH guidance on obtaining minor consent for health care providers and local health departments.

Vaccination:

Interim Clinical Considerations for Use of JYNNEOS – CDC interim guidance on vaccination to prevent mpox.
CDPH Vaccine Resources for Providers – Links on vaccine guidance and resources.
CDPH Vaccine Provider and Local Health Department Q&As – Information on vaccine eligibility, pre-exposure and post-exposure recommendations, and vaccine ordering.
Myturn.ca.gov – Online appointment booking for JYNNEOS vaccine.

Mpox Treatment

Pain management and supportive care:

Supportive Care Guidance - CDPH guidance on supportive care measures for patients. 
Clinical Considerations for Pain Management of Mpox - CDC guidance on pain management.

Antiviral guidance:

Mpox Tecovirimat Treatment Information for Providers – CDPH clinical guidance on treatment of mpox with Tecovirimat (TPOXX). 
Treatment Information for Healthcare Professionals – CDC interim clinical guidance and medical counter measures (including TPOXX) available for treatment of mpox.

Tecovirimat(TPOXX) through NIH study referral:

STOMP: Study of Tecovirimat for Mpox – Guides for patients and providers – Printable flyer resources from California PTC for both patients (self-referral / self-enrollment) and clinics.
STOMP: Study of Tecovirimat for Mpox – NIH NIAID Clinical Trials website.

Tecovirimat (TPOXX) ordering for providers via EA-IND protocols:

Guidance for Tecovirimat Use Under Expanded Access Investigational New Drug Protocol during 2022 U.S. Mpox Cases – CDC guidance regarding Tecovirimat use.
Obtaining and Using TPOXX (Tecovirimat) – CDC guidance on how to request TPOXX through the Strategic National Stockpile.

Provider Reporting

Title 17 Reportable Disease and Conditions (PDF) – Mpox and orthopoxvirus infections are explicitly reportable by providers and laboratories to the local health department within 1 working day of identification.
When to Report Mpox on the Death Certificate – CDC guidance on death reporting for providers.

Infection Prevention and Waste Management in Healthcare Setting

Infection Prevention and Control of Mpox in Healthcare Settings – CDC guidance that includes transmission prevention, patient placement and PPE.

Workplaces covered by the Cal/OSHA Aerosol Transmissible Diseases (ATD) standard (PDF) should consult those regulations for additional applicable requirements. See  Cal/OSHA Guidance on Mpox Virus for Employers Covered by Section 5199  (PDF).

California Prevention Training Center's " Preventing Occupational Mpox Transmission in Outpatient Clinics" - presents real-world strategies that allow clinics to care for patients with mpox as safely and effectively as possible.
Mpox Medical Waste Management – CDPH interim guidance for medical waste management. Note: Clade I MPXV is Category A infectious substance, whereas Clade II has been determined to be Category B.

Laboratories

Information for Laboratory Personnel – CDC information on laboratory procedures and testing, including RT-PCR assays and PPE.
Preparation and Collection of Specimens – CDC best practices for specimen collection, storage, and shipment of specimens for mpox diagnosis.
CDPH Viral and Rickettsial Disease Laboratory (VRDL) monkeypox virus PCR test order
Title 17 Reportable Disease and Conditions (PDF) – Mpox and orthopoxvirus infections are explicitly reportable by providers and laboratories to the local health department within 1 working day of identification.
Mpox Medical Waste Management – CDPH interim guidance for medical waste management. Note: Clade I MPXV is Category A infectious substance, whereas Clade II has been determined to be Category B.

As a reminder, mpox testing is available at many commercial laboratories and providers should consult their laboratory for submission criteria. Providers may otherwise contact their local health department to inquire about testing through the public health lab if needed.

Local Health Departments

Topics: Case Reporting | Case Investigation and Other Setting-Specific Guidance | Vaccine Distribution and Administration | Messaging and Communications Toolkit

Case Reporting

Case Definitions for Use in the 2022 Mpox Response – CDC guidance for case definitions and criteria, including for reinfections.

Interim reinfection reporting to CDPH:

Create new incident ID for suspected reinfection cases and attach ELR.
Assess for case criteria per CDC definition (i.e., symptom resolution between episodes) and note “reinfection” within notes tab along with primary infection incident ID.
If possible, forward any specimens that may meet reinfection criteria to VRDL for WGS.
Send secure email to stdcb@cdph.ca.gov

Death reporting – See CDC MMWR on mpox-associated deaths. For public health surveillance in CalRedie, use death certificate (i.e., if mpox is listed on the death certificate as a primary or significant contributing factor).
See CalRedie document repository or LHJ SharePoint for further reporting information—email mpoxadmin@cdph.ca.gov to request SharePoint access.

Case Investigation and Other Setting-Specific Guidance

Isolation and Infection Control at Home – CDC isolation guidance for persons with suspected or confirmed mpox infection.
Mpox General Guidance (PDF) - CDPH quicksheet for local health departments. 
Mpox Case and Cluster Investigation Protocol for LHDs – requires local health department SharePoint access, email mpoxadmin@cdph.ca.gov to request access.
Mpox Guidance for Congregate Settings - CDPH guidance for congregate settings, including homeless shelters and correctional facilities.
Considerations for Reducing Mpox Transmission in Congregate Living Settings – CDC guidance for prevention of mpox in congregate settings.
Mpox Considerations for Childcare and School Settings – CDPH guidance for administrators and staff of schools and childcare settings.

Vaccine Distribution and Administration

Prioritizing inventory of JYNNEOS smallpox and Mpox vaccine – CDPH updated guidance on administering 2nd doses at recommended 28-day interval.
Consent to Medical Services for the Treatment of Mpox in Minors - CDPH guidance on obtaining minor consent for health care providers and local health departments.
Patient and Provider Choice on Route of Administration of Jynneos Mpox Vaccine - CDPH guidance on intradermal administration.
Mpox Mpox Vaccine Provider and LHD Q&A – CDPH commonly asked questions and answers.

Messaging and Communications Toolkits

Mpox General Public Communications Toolkit – CDPH webpage fact sheets, videos, and graphics on mpox.
Mpox Campaign Toolkit - CDPH communication webpage for community-based organizations and local health departments.

Community Guidance

Topics: How to Prevent Mpox | If You Have Mpox | Prevention in Non-Clinical Settings

How to Prevent Mpox

How to Protect Yourself – CDC guidance on steps to protect yourself from getting mpox.
If You’re a Close Contact to Mpox – CDC guidance on what to do if you are exposed to mpox.
Make a Vaccine Appointment – Book appointments at a clinic near you.
Mpox Q&As – CDPH information for commonly asked questions and answers. – CDPH information for commonly asked questions and answers.
Travel Guidance – CDC guidance for international travelers and mpox outbreaks outside the U.S.

If You Have Mpox

Isolation and Infection Control at Home – CDC information to prevent spread to others.
Cleaning and Disinfecting – CDC information about cleaning and disinfecting at home and other non-healthcare settings.
Tell Your Partner – Visit tellyourpartner.org to anonymously notify persons of exposure.
STOMP Study for TPOXX (PDF) – Information about the clinical trial evaluating the antiviral treatment TPOXX (Tecovirimat) for mpox infections; patients may talk with their provider or call the study hotline to self-enroll.

Prevention in Non-Clinical Settings

Mpox Considerations for Childcare and School Settings – CDPH guidance for administrators and staff of schools and childcare settings. 
Mpox Infection Control in Congregate Settings – CDPH guidance for congregate settings including homeless shelters and correctional facilities. 
Considerations for Reducing Mpox Transmission in Congregate Living Settings – CDC guidance for prevention of mpox in congregate settings.

How Can We Help You?

Connect with CDPH for additional mpox resources.

Contact CDPH STD Control Branch Mpox Team

If you need further clarification or have questions, comments, and concerns regarding CDPH Mpox, submit an inquiry.

Contact Your Local Public Health Department

Reach out to your local health department with any questions.

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